Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy.

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our Privacy Policy and User Agreement for details.

Some 50 years since Morris’ first study there is now international consensus on the health benefits of physical activity. The US Surgeon General in 1996 and now in March of this year the Chief Medical Officer published major public health reports on the health benefits of physical activity.

Walking prevalence varies according to type of walking. Walking is socially patterned but the pattern varies by walking purpose. Long, brisk paced walks are more common among affluent groups, whereas walking for transport reveals an opposite trend. The availability of physical activity facilities declines with level of deprivation Areas in most need of facilities to assist people live physically active lifestyles have fewer resources The likelihood of this differential effect is magnified by the invitation and dose of physical activity offered. You need a car to give up or exchange a car journey for another mode of transport Car use journeys to work, school, shops, This choice is more limited and frustrating if you don’t have access to a reliable and cheap public transport system

The availability of physical activity facilities declines with level of deprivation Areas in most need of facilities to assist people live physically active lifestyles have fewer resources

Odense, Copenhagen

How you work with target group matters Do not underestimate the power of a good therapeutic relationship Evidence offers a direction for practice (with details) It’s art and it’s science There are other things in people’s lives which influence their physical activity choices over which we and them have little or no control Keeping adding to your toolbox

How you work with target group matters Do not underestimate the power of a good therapeutic relationship Evidence offers a direction for practice (with details) It’s art and it’s science There are other things in people’s lives which influence their physical activity choices over which we and them have little or no control Keeping adding to your toolbox

10.
The density of exercise facilities by quintile of deprivation for the county of Kent in Southeast England Availability of physical activity facilities declines with level of area deprivation

11.
Attitudes <ul><li>How are attitudes constructed? </li></ul><ul><ul><li>KAB </li></ul></ul><ul><li>What is a social norm? </li></ul><ul><li>Change4Life </li></ul><ul><li>Within families not within communities </li></ul><ul><ul><li>Increase the desirability of physical activity behaviour </li></ul></ul><ul><ul><li>Decrease the desire to be sedentary </li></ul></ul><ul><ul><li>Change attitudes to behaviour or change environment, </li></ul></ul><ul><ul><ul><li>places acceptable for the behaviour </li></ul></ul></ul><ul><ul><ul><li>More acceptable, normal </li></ul></ul></ul>

12.
MINDSPACE: Influencing behaviour through public policy was a joint commission by the Cabinet Office and the Institute for Government. It shows how the latest insights from the science of behaviour change can be used to generate new and cost-effective solutions to some of the current major policy challenges, such as reducing crime, tackling obesity and climate change.

13.
So what does affect our behaviour? MINDSPACE. Influencing behaviour through public policy. Cabinet Office & Institute for Government, 2010.

16.
The effectiveness of environmental change interventions to promote physical activity <ul><li>NICE review – physical activity and environment </li></ul><ul><li>Systematic reviews have also found some evidence to support the impact of large scale environmental changes on physical activity </li></ul><ul><li>A combination of changes to working practices, policies and the physical environment encouraged adults to maintain their vigorous physical activity and fitness </li></ul><ul><li>Active travel interventions must contain environmental supports to sustain individual choice (i.e. public transport) </li></ul>

17.
Using the environment to promote active living <ul><li>Successful active travel interventions blend changes to places, people and policies </li></ul><ul><li>European examples demonstrate what can be achieved in the long term </li></ul><ul><li>NICE Physical activity and Environment public health guidance offers direction </li></ul>

20.
The Cycling Demonstration Towns programme <ul><li>First phase: October 2005 – October 2008 </li></ul><ul><li>All towns funded at approx £5 per head per year, matched by the local authority </li></ul><ul><li>Comprehensive evaluation </li></ul>

22.
The effectiveness of community-based approaches using person-focused techniques to promote physical activity <ul><li>community wide campaigns using person focused techniques </li></ul><ul><ul><li>Sustained changes in physical activity up to one year post intervention </li></ul></ul><ul><ul><li>those tailored to people’s needs </li></ul></ul><ul><ul><li>targeted at the most sedentary or at those most motivated to change </li></ul></ul><ul><ul><li>delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualised marketing) or through groups </li></ul></ul><ul><ul><li>Interventions which provide people with professional guidance about starting an exercise programme and then provide on going support </li></ul></ul>

24.
The findings of this review indicate that professional advice and guidance with continued support can encourage people to be more physically active in the short to mid-term.

26.
The effectiveness of community-based approaches using person-focused techniques to promote physical activity <ul><li>community wide campaigns using person focused techniques </li></ul><ul><ul><li>Sustained changes in physical activity up to one year post intervention </li></ul></ul><ul><ul><li>those tailored to people’s needs </li></ul></ul><ul><ul><li>targeted at the most sedentary or at those most motivated to change </li></ul></ul><ul><ul><li>delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualised marketing) or through groups </li></ul></ul><ul><ul><li>Interventions which provide people with professional guidance about starting an exercise programme and then provide on going support </li></ul></ul>

28.
Limitations of evidence base <ul><li>Measurement </li></ul><ul><li>Study design </li></ul><ul><li>Expense </li></ul><ul><li>Population sample </li></ul><ul><li>Applicability to the UK from international work </li></ul><ul><li>Differential effects on different population groups </li></ul><ul><li>Very little from the fitness industry </li></ul>

29.
Other options <ul><li>Reducing sedentary behaviours </li></ul><ul><li>Provision of free swimming and/or free sports centre access </li></ul><ul><li>Discounted or free public transport provision for children or the elderly </li></ul><ul><li>The use of local authority regulatory, legislative and policy guidance on physical activity promotion </li></ul><ul><li>The impact of combined programmes to tackle healthy eating and physical activity together at a community level </li></ul><ul><li>The recruitment of those in most need to participate in community based physical activity programmes </li></ul><ul><li>YMCA Activate England, Walking For Health Initiative, Sport Action Zones, Positive Futures </li></ul>

31.
<ul><li>Evidence base does suffer limitations (maturity) but it offers a direction of travel </li></ul><ul><li>Evidence to support smaller more individually focused activities rather than larger scale community interventions </li></ul><ul><li>Recommend multiple level interventions </li></ul><ul><ul><li>Environment, legislation, fiscal, policy approaches </li></ul></ul><ul><ul><li>Support individual approaches as part of RF prevention and management </li></ul></ul><ul><li>Populate our list of options </li></ul>Conclusions

32.
Public Health White Paper Late 2010 <ul><li>Local authorities, who will employ the Director of Public Health </li></ul><ul><li>Public Health Service in place, with ring-fenced budget and local health improvement led by Directors of Public Health in local authorities </li></ul><ul><ul><li>Budget allocated to reflect relative population health outcomes, with a new health premium to promote action to reduce health inequalities. </li></ul></ul><ul><li>NICE put on a firmer statutory footing </li></ul><ul><li>Health and Wellbeing boards (2012) </li></ul>